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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

‘Intensive Drug Monitoring’

Hey all,

I’m trying to get a clear definition of ‘Drug therapy requiring INTENSIVE MONITORING’ to toxicity on the Risk Table.
Google has confused me further.
I’m trying to decipher when it would be in that category verses ‘prescription drug management’ in the moderate.

An example I have that one of my Drs brought up to me is a drug called Noctiva which treats Nocturia.
One of the main side effects is hyponatremia which CAN be life-threatening. So he will need to closely monitor the patients sodium levels.

But my question is what exactly is ‘intensive monitoring for toxicity’. The internet definitely points me to when the patient is in the hospital and getting IV medications of controlled substances and such that might need to be titrated, but does this also apply to clinically monitoring? I think I read that this drug recommends checking sodium levels bi weekly or monthly.

I see that Gentamicin is on a list of requiring intensive monitoring for toxicity. We give this often for UTI’s. So, if the patient has a UTI and we give them this injection (I know I still need 2 out of 3 in MDM), but I can put it in the high spot on the risk table??

Medical Billing and Coding Forum

‘Intensive Drug Monitoring’ on Risk Table

Hey all,

I’m trying to get a clear definition of ‘Drug therapy requiring INTENSIVE MONITORING’ to toxicity on the Risk Table.
Google has confused me further.
I’m trying to decipher when it would be in that category verses ‘prescription drug management’ in the moderate.

An example I have that one of my Drs brought up to me is a drug called Noctiva which treats Nocturia.
One of the main side effects is hyponatremia which CAN be life-threatening. So he will need to closely monitor the patients sodium levels.

But my question is what exactly is ‘intensive monitoring for toxicity’. The internet definitely points me to when the patient is in the hospital and getting IV medications of controlled substances and such that might need to be titrated, but does this also apply to clinically monitoring? I think I read that this drug recommends checking sodium levels bi monthly or monthly.

I see that Gentamicin is on a list of requiring intensive monitoring for toxicity. We give this often for UTI’s. So, if the patient has a UTI and we give them this injection (I know I still need 2 out of 3 in MDM), but I can put it in the high spot on the risk table??

Medical Billing and Coding Forum

Medicare to Cover Glucose Monitoring on Smartphones

The Centers for Medicare & Medicaid Services (CMS) is modifying its Medicare coverage policy for continuous glucose monitors (CGMs) to support their use in conjunction with smartphones, including the data sharing function CGMs provide. Medicare coverage of therapeutic CGMs began in January 2017, but the policy limited their use in conjunction with smartphones. CMS is removing this limitation in […]
AAPC Knowledge Center

3 New CPT Codes for Remote Monitoring

Fifty professional societies and healthcare providers wrote a letter to Seema Verma, the secretary of the Centers for Medicare & Medicaid Services (CMS) asking that the agency reimburse three new CPT codes for remote monitoring. Remote Monitoring More than 99091 While expressing their gratitude that the 2018 Medicare Physician Fee Schedule includes 99091 Physician/healthcare professional collection and interpretation […]
AAPC Knowledge Center

Regarding glucose monitoring in home care

Dear AAPC members,
Greetings!
I have a doubt regarding the following service:
Home care nurses doing glucose reagent strip for patient on home during their home nursing services. We have a doubt that 82948 is billable code for this service or not?. Because we have other home care code i.e., 99600-Unlisted home nursing service procedure code.

Medical Billing and Coding Forum

Counting checking PDMP (Prwescription Drug Monitoring Program) as Complexity of Data

Email sent to Our Medical Director:
I noticed that ‘and/or checked PDMP’ was added to <Reviewed old records…> check box for Complexity of Data for coding points.
If this is being done as part of Agency protocol, it does not count for coding purposes and should not be included as it may result in up-coding. There is no complexity in decision-making to just follow a protocol.
Unsure how this got changed as this was not the way it was set up per my prior recommendation, and my professional opinion is: this verbiage should be removed and another check box added: <PDMP checked per Agency protocol> that does not link to coding.
I have no problem educating prescribers to check <Reviewed old Records> when they check the PDMP on established patients, not on controlled meds (ie not part of protocol) and document why: “checked PDMP as client has history of Benzo abuse” or “ checked PDMP as client has a SUD Dx” or “client has been using up recent prescriptions prior to renewal date; checking PDMP for possible prescription abuse”. This does show additional ‘work’ on the part of prescribers which may allow for higher coding level.

Experienced E/M coders-please provide input as the Director disagrees with my stance

Medical Billing and Coding Forum

Oxygen Removed from Non-Moderate Sedation Post-Procedure Monitoring

The Centers for Medicare & Medicaid Services (CMS) finalized in the 2018 Medicare Physician Fee Schedule (MPFS) final rule their proposal to remove oxygen gas supply item (SD084) from a series of CPT codes that were previously valued with moderate sedation as an inherent part of the procedure. It occurred to CMS, after finalizing the […]
AAPC Knowledge Center